Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $173.78 / $371.54	Facility		$114.82	$173.78	$371.54
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $28.84 / $346.74 / $426.58	Facility	25	$28.84	$346.74	$426.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $177.83 / $371.54	Professional		$109.65	$177.83	$371.54
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $162.18 / $245.47 / $371.54	Professional	25	$162.18	$245.47	$371.54
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $208.93 / $288.40	Professional		$138.04	$208.93	$288.40
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $162.18 / $199.53 / $263.03	Professional	25	$162.18	$199.53	$263.03
BCBS Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $229.09 / $2,041.74	Facility		$169.82	$229.09	$2,041.74
BCBS Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $190.55 / $229.09	Professional		$151.36	$190.55	$229.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $213.80 / $323.59	Professional		$151.36	$213.80	$323.59
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $229.09 / $457.09	Professional		$134.90	$229.09	$457.09
Hally Health Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $100.00	Facility		$100.00	$100.00	$100.00
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $173.78 / $275.42	Professional		$165.96	$173.78	$275.42
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $33.11	Professional		$32.36	$33.11	$33.11
United Facility/Professional Facility Modifier Low / Median / High Price $199.53 / $323.59 / $467.74	Facility		$199.53	$323.59	$467.74
United Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $190.55 / $288.40	Professional		$120.23	$190.55	$288.40